Nokea
Which of the following provides the best evidence that the dietary measures to control functional hypoglycemia are therapeutic?
- A. The client experiences fewer incidences of weakness and tremors.
- B. The client experiences fewer incidences of thirst and dry mouth.
- C. The client experiences fewer incidences of muscle spasms and fatigue.
- D. The client experiences fewer incidences of hunger and abdominal cramps.
Correct Answer: A
Rationale: Reduced weakness and tremors indicate stabilized blood glucose levels in functional hypoglycemia.
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During the physical assessment of this client, which finding the nurse's blood, the observer?
- A. Shortened height
- B. Enlarged hands
- C. Gonadal atrophy
- D. Loss of teeth
Correct Answer: B
Rationale: Acromegaly, caused by excess growth hormone, leads to enlarged hands due to soft tissue and bone overgrowth.
The client diagnosed with Addison's disease is admitted to the emergency department after a day at the lake. The client is lethargic, forgetful, and weak. Which intervention should the nurse implement?
- A. Start an IV with an 18-gauge needle and infuse NS rapidly.
- B. Have the client wait in the waiting room until a bed is available.
- C. Obtain a permit for the client to receive a blood transfusion.
- D. Collect urinalysis and blood samples for a CBC and calcium level.
Correct Answer: A
Rationale: Lethargy, confusion, and weakness suggest Addisonian crisis; rapid NS infusion corrects hypotension and dehydration. Waiting, transfusions, and labs are inappropriate first steps.
The nurse reviews the HCP's orders for the newly admitted client diagnosed with DKA. Which order should the nurse question?
- A. Administer D5W intravenously (IV) at 125 mL per hour
- B. Administer KCL 10 mEq in 100 mL NaCl IV now
- C. Give sodium bicarbonate IV per pharmacy dosing if arterial pH is less than 7.0
- D. Start regular insulin infusion per protocol; titrate based on hourly glucose level
Correct Answer: A
Rationale: In DKA, the blood glucose level is above 300 mg/dL. Additional glucose will increase the glucose level further. Initially 0.45% or 0.9% sodium chloride (NaCl) is administered for fluid resuscitation.
The health-care provider has ordered 40 g/24 hr of intranasal vasopressin for a client diagnosed with diabetes insipidus. Each metered spray delivers 10 g. The client takes the medication every 12 hours. How many sprays are delivered at each dosing time?
Correct Answer: 2 sprays
Rationale: Total dose: 40 g/24 hr, split every 12 hr = 20 g/dose. Each spray = 10 g, so 20 g ÷ 10 g/spray = 2 sprays per dose.
The client is hospitalized with a tentative diagnosis of Cushing's syndrome. Which laboratory findings should the nurse expect if the diagnosis of Cushing's syndrome is confirmed? Select all that apply.
- A. Hyperglycemia
- B. Eosinophilia
- C. Hypocalcemia
- D. Hypokalemia
- E. Thrombocytopenia
- F. Elevated serum cortisol
Correct Answer: A,D,F
Rationale: Cushing's syndrome causes hyperglycemia, hypokalemia, and elevated serum cortisol due to excessive adrenocortical activity.